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Diagnostic value of multi-slice spiral CT in lesions of ileocecal acute abdomen |
ZHAO Ming-yi CHEN Tao |
Department of General Surgery,People′s Hospital of Daxing District in Beijing City,Beijing 102600,China |
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Abstract ObjectiveTo explore the diagnostic value of multislice spiral CT(MSCT)for the acute abdominal disease in the ileocecal region in order to guide the rapid diagnosis of this kind of disease.MethodsThe clinical data of 97 patients with suspected ileocecal acute abdomen admitted to our hospital from January 2016 to December 2017 were retrospectively analyzed.All patients were examined by MSCT before operation.Taken surgical results as standard:the value of MSCT in diagnosing acute ileocecal lesions was evaluated.At the same time,the CT manifestations of acute abdomen in different ileocecal parts were analyzed.ResultsAmong the 97 cases of suspected ileocecal acute abdomen,85 cases were diagnosed and 12 cases were excluded:including in 52 cases of appendicitis,20 cases of intussusception and 13 cases of diverticulitis.The sensitivity,specificity,positive predictive value,negative predictive value and coincidence rate of appendicitis,intussusception and diverticulitis were 88.46%,66.67%,95.83%,40.00%,86.21%and 85.00%,66.67%,94.44%,40.00%,82.61%and 92.31%,100.00%,100.00%,75.00%,86.21%.The total coincidence rate of MSCT and surgical diagnosis was 86.60%.The main CT of appendicitis is the obvious thickening of the outer diameter of the appendix,the surrounding inflammatory changes and the permeation of the appendectomy.The perforation of the appendix is perforated by the omentum,forming a lump like structure.The center is low density and thick and uneven.The tumor like changes were seen under the intussusception CT and appeared at the same time with inflammation.The mass of the intussusception was round or ring when the CT scan was vertical.The lump was visible in the lump.The intussusception tube showed obvious“double bowel sign” and “comet tail sign” when CT scanning was not vertical.Diverticulitis CT showed inflammatory infiltration around the diverticulum,showing exudation and thickening of the adipose tissue.In severe cases,diverticulum hemorrhage,perforation and local abscess were seen.ConclusionThe detection rate of acute abdominal disease in appendicitis,diverticulitis and intussusception by MSCT technique is in good agreement with the diagnosis of surgical pathology.It can clearly show the involvement of the lesions and surrounding organs and tissues,and can be used as the first choice for the diagnosis of acute abdominal disease in the ileoceces.
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